Insomnia & sleep disorders

We spend a third of our lives asleep. Since Mother Nature devotes so much time to sleep, it is inevitable that sleep plays an important role in our overall functioning. Our motivation, energy, concentration, behaviour, memory, mood and learning ability are all influenced by sleep and lack of sleep. Sleep problems are the basis of a wide range of (mental) health problems. Sleep problems can cause or worsen the symptoms of ADHD, depression, OCS, anxiety and general learning, behavioural or mood disorders.

CBS research (2018) shows that 1 in 5 Dutch people experience sleeping problems. Other studies show that today’s children sleep 75 minutes less per night than they did 100 years ago. People who sleep less than necessary often do not notice that their functioning is lower than that of well-rested people. So sleeping problems may even occur more often than we think.

In some cases, sleeping problems such as insomnia can be overcome with a few simple lifestyle changes. This also leads to positive changes in other areas of health. Whether a sleep disorder is part of a mental illness or is a stand-alone problem, it is important to appreciate sleep and recognize its important link to our health and well-being.

Sleep disorders can be caused by at least one of the following categories:

Psychological causes

Sleep issues are common in people who have experienced a distressing situation, such as grief, trauma, a difficult relationship or work environment. These are psychological causes of a sleep disorder which are often temporary and can be helped when the person learns strategies to cope better with these experiences. However, in many cases, prolonged sleep issues may actually cause or exacerbate depression, anxiety and ADHD.

Substance-related causes

Alcohol, caffeine, illicit or prescribed medications directly affect our central nervous system which can then alter the body’s natural ‘circadian rhythm’ (or “sleep clock“). Even when these substances feel to have a sleep-inducing effect, this is often due to the substance’s sedative properties, which is different from falling asleep naturally.

Medical causes

Diabetes, neurological disorders, breathing issues, heartburn and restless legs syndrome are examples of chronic conditions which can have a negative effect on sleep. Specialist physicians should be consulted in these cases to make the best possible effort to alleviate the illness. Sleep and insomnia treatment should, therefore, be seen as a complex interdependent process, which would ideally be addressed concurrently to the illness.

Environmental causes

Sleep is regularly influenced by a number of evolving environmental conditions that have emerged from a rapidly changing society. Light pollution, noise, shift work, unhealthy eating; all play a role in our health and affect sleep more than is generally assumed. Exposure to bright blue light in the evening (or insufficient exposure to sunlight during the day) also plays an important role in sleep.

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Neurofeedback programs to help with sleep

There are many easy and sustainable changes we can make in our daily routine to help us sleep, but some people may find they need extra help in “quietening“ their minds and regulating brain activity.

A QEEG analysis will help determine if this is the case and an appropriate, evidence-based neurofeedback training program may be recommended as a way for the patient to train their brain to self-regulate overactive brain activity associated with feelings of anxiety, obsessions and/or hyperactivity. Studies show Neurofeedback, when delivered correctly and following scientifically-proven protocols, can be effective in 75% of cases (Arns et al. 2012).

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Understanding the effects of blue light on the body’s internal clock

Smartphones, tablets, laptops, computers, LED and fluorescent light bulbs emit a high spectrum blue light the human body more naturally needs during daylight hours. In the morning exposure to blue spectrum light from the sun helps calibrate the body’s internal “circadian” clock, making it easier to fall asleep at night.

In the evenings our eyes ideally need to avoid blue light to give our bodies the signal it is the time to unwind and fall asleep. Overexposure to blue light in the evenings counteracts the body’s natural release of sleep-inducing melatonin. It helps to be mindful of your exposure to blue light and while it is virtually impossible to block out all blue spectrum light sources there are a few simple changes you can make to help limit your exposure.

Here are some simple solutions to avoid exposure to blue light in the evenings, contributing to your overall insomnia treatment:

  • Use applications on your smartphone, tablet, laptop or desktop computer, which automatically adjusts the colours of your display to warmer colours at the appropriate times in your location:
    • If you use an Apple device (iPhone, iPad, Mac, MacBook, Apple Watch) make sure to set the Nightshift function.
    • If you use Windows 10, Windows Phone or a Google Pixel device, make sure to set the Night Light function.
    • For all other smartphone and tablet devices, you can access the Blue Light Filter app
    • For all other operating systems on a desktop or laptop computer, you can download and install F.Lux software
  • Keep your household lighting dim, especially in the 2 hours before bedtime. Avoid using your bright LED, Fluorescent (CFL) or Halogen lights (commonly installed as energy saving options in many households). In the 2 hours before bedtime opt for turning on dim light sources such as a low wattage table lamp, ideally fitted with an incandescent bulb or special low blue light bulbs
  • A simple solution is to wear Blue Light Blocking Glasses (also available to fit over prescription glasses) 2 hours before bedtime. These are an inexpensive solution and ideal if you are watching programs/ playing games on a TV, tablet or laptop.

Tips to help your body prepare for sleep naturally

Keep a routine

The body “gets used“ to falling asleep at certain times, try to get your body into a healthy routine and stick to it. On weekends, the time you wake up shouldn’t differ more than 1.5 hours from your regular wake up times during the week.

Be mindful of “screen time“

Try to replace “screen time“ with different activities; reading a book, yoga, relaxing to music. Consider blue light blocking glasses, or dimming the light of the screen to warmer colours if you do watch something on a screen.

Exercise during the day

Regular cardiovascular exercise during the day, particularly in the morning or early afternoon, can help deepen sleep. It is not recommended to exercise within the 2 hours before bedtime.

Avoid napping during the day

If you take regular or long naps throughout the day, it will make it harder to fall asleep at night, because you will not have worked up enough “sleep pressure“ or tiredness.

Understand the effects of caffeine

Coffee, tea, cola, many other soft drinks and also chocolate contain caffeine. Your body will find it more difficult to fall asleep if there is caffeine in your system 4 – 6 hours before bedtime.

Understand the effects of alcohol

Many people believe alcohol helps them fall asleep, however, a few hours after drinking, when the alcohol levels in your blood start to fall, there can be a stimulant or wake-up effect, disrupting your circadian rhythm.

Natural sleep vs. sedation

Sleeping pills induce sedation rather than natural sleep, and thus should not be used as an insomnia treatment. Sedation can disrupt our natural circadian rhythm, which in turn affects mood, attention and many other negative symptoms in mental health.

Check with your doctor…

… if you think that one of your mentioned medicines prevents you from falling asleep naturally. Melatonin supplements are only useful when the sleeping problems are caused by a limitation of the melatonin rhythm. Incorrect use may also cause sleeping problems in maintenance. When you start taking melatonin supplements, it is important to first have your own melatonin rhythm investigated.

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